Obstetrical forceps



Filed Jan. 30, 1934 E .LaBnec/i? Zlnnzntur Patented Aug. 6, 1935 UNITED STATES OBSTETRICAL FORCEPS Frank A. La Breck, Eau Claire, Wis.

Application January 30,

4 Claims.

This invention aims to provide novel means for assembling the spoons of a pair of obstetrical forceps with the lever members of the forceps for compound relative movement, to the end that the head of the child may follow the path of least resistance, even though the tractive effort may not be applied in exactly the right direction.

It is within the province of the disclosure to improve generally and to enhance the utility of devices of that type to which the invention appertains.

With the above and other objects in view, which will appear as the description proceeds, the invention resides in the combination and arrangement of parts and in the details of construction hereinafter described and claimed, it being understood that changes in the precise embodiment of the invention herein disclosed, may be made within the scope of what is claimed, without departing from the spirit of the invention.

In the drawing:

Fig. 1 shows, in side elevation, a pair of obstetrical forceps constructed in accordance with the invention;

Fig. 2 is a top plan;

Fig. 3 is an elevation showing one of the spoons;

Fig. 4 is a section on the line 4-4 of Fig. 1;

Fig. 5 is a section on the line 55 of Fig. 1;

Fig. 6 is a plan of the connector.

In carrying out the invention, there is provided a pair of levers I, including handles 2, the levers being crossed and detachably interlocked at 3, in the usual way. Each of the levers I is provided, near to its working end, with a tapered neck 4, merging into a disk-like head 5, which, as shown in Fig. 5, is somewhat thicker than the adjacent portion of the lever I.

The spoons of the instrument are marked by the numeral 6, and a means is provided for affording a multi-movement pivotal connection between the spoons and the levers I. Having this consideration in mind, the head 5 of each lever I is surrounded by a circular connector I, having an opening 8 which receives the tapered neck 4 of the lever, the outer surface of the connector I being flush with the outer surface of the head 5 of the lever I, as can be seen in Fig. 5. Means is supplied for uniting the connector I with the head 5 for tilting movement transversely of the length of the lever, and this means may be a pivot member or pin 9, having its ends secured in the connector I, the pivot member being mounted to turn in the head 5, the

1934, Serial No. 709,038

connector thus being mounted on the head 5 for tilting movement.

The spoon ii is provided intermediate its ends with a circular opening H), into which the connector i is threaded, as shown at II, the spoon 5 therefore being mounted to turn on the conhector, as indicated by the solid line and dotted line showing of Fig. l, in a direction at right angles to the movement which the spoon derives by reason of the fact that the connector I can tilt with respect to a line represented by the axis of the pivot member 8. The pivot member 9 and the connector l aiford a means whereby the spoons 6 are mounted intermediate their ends for tilting movement toward and away from the plane A-B of Fig. 2, toward which the levers I close, and from which they open; and the connectors i, being threaded into the spoons 5, afford a means whereby the spoons are mounted intermediate their ends for lateral swinging movement in approximate parallelism to said plane. As shown best in Fig. 3, the spoons 6 are provided on their outer faces with recesses I2, leading to the openings ID and receiving the necks 4 and adjacent portions of the levers I, so that as disclosed in Fig. 2, for instance, the outer surfaces of the levers are flush with the outer surfaces of the spoons.

The head of the child, with the spoons 6 in position, follows the birth canal, because the spoons E can turn on the threaded connector I. The head follows the path of least resistance, even though the traction be from an angle not in line with the regular birth canal. During the descent of the head, with the forceps and traction in progress, the head often comes in contact with and is obstructed in its descent by the symphysis pubis. When this occurs, the head dips downward, and when past the obstruction, the head rises again in the birth canal, thus following the path of least resistance to the exit, in spite of the fact that the pull may have been improperly directed. This makes the device a very valuable instrument, even in the hands of accoucheurs of limited experience. 45

The head of the child is grasped by the application of the right blade, after the left blade is in position, as in any other common obstetrical forceps, and the usual lock indicated generally at 3, and of well-known construction, is employed. There is provision for a lateral deviation of the head either way, in case of lateral obstruction, as from a tumor in the birth canal, or other constructions so often encountered. The swing of the end of the levers I and their handles 2 with respect to the pins 9 makes allowance for this motion.

The movement provided by the parts I and 9 frees the head from any hinderance to swinging movement, or to fiexion and extension on the cervical vertebrae, due to the pull of the physician. The head can swing gradually and automatically, and flex or extend to conform to the diameter of the birth canal, in spite of the pull exerted upon it. The swinging movement, fiexion and extension, are due to pressure of the soft and bony portions of the mothers body, especially from the rear.

By means of the Kristiller technique, this pressure can be replaced artificially, if the physician presses the buttocks of the child downward by exerting pressure on the abdomen: but this method can only be used under certain conditions which do not need to be disclosed here. It is possible to replace the natural labor powers by a forceps operation, which conforms as closely as possible to the natural conditions.

It is further intended that the instrument be constructed as light as possible, especially the spoons 6. Often it is a question of a portion of a millimeter whether they will pass between the head and the walls of the birth canal. The device can easily assist in delivering the head at the exit of the birth canal where known instruments are absolutely excluded, since such instruments are useful only in pulling downward and in a horizontal plane. In negotiating the pelvic exit, with many forms of known apparatus, as soon as the physician must draw upward and backward, he loses the possibility of further directing the movements of the head, and in such instances he must hold the pulling handles. With my forceps, however, this is not necessary, because there is a firm bond between the physician and the forceps, so that during every phase of the birth, he is able to control the forceps, and through them, the head of the child.

Concerning the meaning of the elastic inser tion, it is well to observe that the most recent researches have indi ated that the birth mecha= nism is largely a question of operative elastic forces which move the head forward. The pressure forces of the mothers body do not work continually, but the forces which move the child occur according to the pauses between labor pains. Moreover, the work of nature does not take place in jolts, and the forceps herein disclosed conforms to that important factor.

The elastic pressure of nature is replaced by an elastic pair of forceps. Practically, this is continually kept in mind, as the physician has to avoid any thrusting or tearing. Experience has indicated that failure in this respect may result in fatal lacerations of the soft portions of the generative canal, irrespective of possible injuries to the child. When one considers that many known kinds of forceps attack the soft portions with a stiff pull and without flexibility, the above observation becomes easily understood, and the unnatural stifi pull, without flexibility in the forceps, is easily recognized as detrimental. The summary of the advantages of this forceps is as follows:

l. The provision of a pair of obstetrical forceps so constructed that when in place and locked, and traction applied on the head, the head is free to flex and extend freely to follow in the path of least resistance.

2. The provision of means which facilitate the swinging movement of the childs head.

8. The provision of means for facilitating the movement of the head along the longitudinal axis of the generative canal.

4. Reduction of the pressure of the spoons 6 to a minimum.

5. Cutting out the stiff bond between the head of the child and hand of the physician, since the head can extend, flex or swing as body pressure directs it.

6. Simple construction, safe manipulation and the possibility of complete asepsis.

What is claimed is:

i. A pair of obstetrical forceps comprising le vers, spoons at the outer ends of the lovers, and means for mounting the spoons intermediate their ends on the levers for tilting movement, with respect to the levers, toward and away from the plane toward which the levers close and from which they open, and for lateral swinging movement in approximate parallelism to said plane.

2. A pair of obstetrical forceps comprising le vers each terminating in a head, a connector pivotally mounted on each head to tilt about an axis which is fixed with respect to the head, and a spoon mounted to turn on each connector.

3. A pair of obstetrical forceps comprising 1evers each having a head which is connected to one of said levers by a reduced neck, a connector about each head and having an opening receiving the neck, a pivot element uniting each connector with one head for tilting movement, spoons, and means for mounting each spoon to turn on one connector.

l. A pair of obstetrical forceps constructed as set forth in claim 3, and further characterized by the fact that said means comprises threads joining the connectors to the spoons and having a double function, in that they provide for the turning movement of the spoons and also afford a separable union between the spoons and the connectors.

FRANK A. LA BRECK. 

